Provider Demographics
NPI:1982645511
Name:HULSE, GEOFFREY L (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:L
Last Name:HULSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2780 FREDERICA ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-5442
Mailing Address - Country:US
Mailing Address - Phone:270-926-4100
Mailing Address - Fax:270-684-4678
Practice Address - Street 1:2780 FREDERICA ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-5442
Practice Address - Country:US
Practice Address - Phone:270-926-4100
Practice Address - Fax:270-684-4678
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY30502207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64305022Medicaid
IN255500BMedicare PIN
KY64305022Medicaid
KY0607501Medicare PIN
KYK036040Medicare PIN